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- Volume 10, Issue 3, 2012
South African Gastroenterology Review - Volume 10, Issue 3, 2012
Volume 10, Issue 3, 2012
Author Reid AllySource: South African Gastroenterology Review 10 (2012)More Less
2012 brought to an end an era with the passing of Solly Marks, the father of South African gastroenterology. We are all indebted to Solly for his extraordinary contribution to gastroenterology in Southern Africa. We will miss his wit, his wisdom and his all pervading presence. The obituary summarises Solly's career and his leading role in gastroenterology.
A clinical audit of colonoscopy in a gastroenterology unit at a tertiary teaching hospital in South Africa : originalSource: South African Gastroenterology Review 10, pp 9 –15 (2012)More Less
Background : Colonoscopy is a valuable tool for diagnosing various colonic pathologies. There is little recent research regarding the use of colonoscopy in South Africa.
Objective : To describe the findings of the audit done on the practice of colonoscopy in a specialised gastroenterology unit (GEU) of a tertiary teaching hospital.
Design : A retrospective audit of colonoscopies performed between the 01 January 2008 and 31 March 2010 in a single gastroenterology unit at Charlotte Maxeke Johannesburg Academic Hospital(CMJAH) was conducted. Details of colonoscopy records were obtained from an administrative database of patient files. No patient specific inclusion or exclusion criteria were applied.
Results : In total 1143 colonoscopies were performed during the study period, and 989 were analysed. The mean age was 63.04 years (10 - 93), 61.58% female, 61.48% were Caucasians and 25.88% were of black ethnicity. The indications for colonoscopies were; screening for colorectal cancer (22.95%), case findings (14.16%) and surveillance (14.96%). Caecal intubation rate (CIR) was 80.08%. Findings included macroscopically normal colons (38.12%), polyps (28.18%) and diverticular disease (23.15%). Of the biopsies obtained during colonoscopy procedures 30.50% were reported as normal colonic mucosa, 10.40% revealed adenocarcinoma and 55.37% were tubular adenomas.
Conclusions : The audit identified a number of shortfalls, which include: poor colonoscopy performance quality as reflected by the low CIR, non standardised colonoscopy reporting format resulting in paucity of information on scope reports, under-representation of the black community, to mention a few. It therefore would appear, based on the findings from this study that there is room for improvement in a number of areas in the practice of colonoscopy in this unit. Further studies may be of value to identify reasons behind these shortfalls.
Source: South African Gastroenterology Review 10, pp 17 –19 (2012)More Less
Eosinophilic oesophagitis (EoE) is a recently recognised immune-mediated inflammatory condition of the oesophagus. The oesophagus has been traditionally thought of as an inert organ incapable of inducing an immune reaction and that it merely transfers food from the mouth into the stomach. However, the oesophagus is now recognised as an immunologically active organ that can recruit eosinophils in the presence of triggering factors.
Source: South African Gastroenterology Review 10, pp 21 –23 (2012)More Less
The accumulation of eosinophils in the gastrointestinal tract is a common feature of numerous disorders, such as drug reactions, helminth infections, hypereosinophilic syndromes, allergic colitis, inflammatory bowel disease, and gastrooesophageal reflux disease.
A subset of these diseases, referred to as primary eosinophil-associated gastrointestinal disorders (EGID), includes eosinophilic esophagitis (EE), eosinophilic gastritis, and eosinophilic gastroenteritis. This review will focus on Eosinophilic Gastroenteritis (EG).
Author Stephen GroblerSource: South African Gastroenterology Review 10, pp 25 –26 (2012)More Less
"Wicked problem" is a phrase originally used in social planning to describe a problem that is difficult or impossible to solve because of incomplete, contradictory and changing requirements. The term 'wicked' is used, not in the sense of evil but rather its resistance to analysis and resolution. Some simply call it a "social mess".
Author Janneke Van der WoudeSource: South African Gastroenterology Review 10 (2012)More Less
Author Naayil RajaballySource: South African Gastroenterology Review 10 (2012)More Less
My time at Groote Schuur was coming to an end. Like my co-fellows, I was going to venture into private practice but little did I know that something much more exciting and adventurous was going to come my way: a Senior Clinical Fellow position at the John Radcliffe Hospital in Oxford working in Professor Simon Travis' world-renowned GI unit.